Systemic Acidosis in Acute Myocardial Ischemia

Niwano, Shinichi; Tojo, Taiki

doi:10.1253/circj.cj-10-0665

Cited by 8 publications

(8 citation statements)

References 13 publications

(5 reference statements)

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“…It has been suggested that the development of arrhythmias during reperfusion is due to the associated acidosis (Orchard et al, 1987; Orchard and Cingolani, 1994; Avkiran et al, 1996; Said et al, 2008; Kapur et al, 2009; Nagai et al, 2010; Niwano and Tojo, 2010; Lascano et al, 2013). However, it is difficult to identify mechanisms underlying these effects of acidosis because the substrates of ventricular arrhythmias change too rapidly to be observed during IRI in patients.…”

Section: Discussionmentioning

confidence: 99%

“…The myocardial injury paradoxically occurs with the acute reperfusion of ischaemic myocardium (Brooks et al, 1995). It has been suggested that reperfusion-induced arrhythmias, one form of myocardial reperfusion injury, are mainly due to the acute acidosis recovery (Nagai et al, 2010; Niwano and Tojo, 2010). In fact, gradual reperfusion induced by ischaemic postconditioning, has been shown to delay restoration of intracellular pH and prevent reperfusion-induced ventricular tachycardia (VT) and ventricular fibrillation (VF) (Avkiran et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

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Mechanisms Underlying the Emergence of Post-acidosis Arrhythmia at the Tissue Level: A Theoretical Study

et al. 2017

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Acidosis has complex electrophysiological effects, which are associated with a high recurrence of ventricular arrhythmias. Through multi-scale cardiac computer modeling, this study investigated the mechanisms underlying the emergence of post-acidosis arrhythmia at the tissue level. In simulations, ten Tusscher-Panfilov ventricular model was modified to incorporate various data on acidosis-induced alterations of cellular electrophysiology and intercellular electrical coupling. The single cell models were incorporated into multicellular one-dimensional (1D) fiber and 2D sheet tissue models. Electrophysiological effects were quantified as changes of action potential profile, sink-source interactions of fiber tissue, and the vulnerability of tissue to the genesis of unidirectional conduction that led to initiation of re-entry. It was shown that acidosis-induced sarcoplasmic reticulum (SR) calcium load contributed to delayed afterdepolarizations (DADs) in single cells. These DADs may be synchronized to overcome the source-sink mismatch arising from intercellular electrotonic coupling, and produce a premature ventricular complex (PVC) at the tissue level. The PVC conduction can be unidirectionally blocked in the transmural ventricular wall with altered electrical heterogeneity, resulting in the genesis of re-entry. In conclusion, altered source-sink interactions and electrical heterogeneity due to acidosis-induced cellular electrophysiological alterations may increase susceptibility to post-acidosis ventricular arrhythmias.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mechanisms Underlying the Emergence of Post-acidosis Arrhythmia at the Tissue Level: A Theoretical Study

et al. 2017

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“…A significantly increased incidence of ventricular tachycardia (VT) and VF has been reported after reperfusion therapy for patients with myocardial infarction and systemic acidosis [ 4 ]. There is evidence that systemic metabolic acidosis is a strong predictor of VT/VF after reperfusion of ST-elevation myocardial infarction associated with inflammation [ 5 ]. However, the causal relationship between systemic acidosis secondary to myocardial ischemia and VT/VF is complex, and the trigger is not always obvious.…”

Section: Discussionmentioning

confidence: 99%

Is It Possible to Maintain Consciousness and Spontaneous Ventilation with Chest Compression in the Early Phase of Cardiac Arrest?

Oksar

Turhanoglu

2016

Case Reports in Anesthesiology

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Chest compression is important in cardiopulmonary resuscitation. However, life support algorithms do not specify when chest compression should be initiated in patients with persistent spontaneous normal breathing in the early phase after cardiac arrest. Here we describe the case of a 69-year-old man who underwent femoral bypass surgery and was extubated at the end of the procedure. After extubation, the patient's breathing pattern and respiratory rate were normal. The patient subsequently developed ventricular fibrillation, evident on two monitors. Because defibrillation was ineffective, chest compression was initiated even though the patient had spontaneous normal breathing and defensive motor reflexes, which were continued throughout resuscitation. He regained consciousness and underwent tracheal extubation without neurological sequelae on postoperative day 1. This case highlights the necessity of chest compression in the early phase of cardiac arrest.

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“…Mild acidity is characteristic of acidosis and has been observed in hypoxic systems (e.g., ischemic and cancer cells). Since acidosis plays a critical role in the initiation of brain [141,142] or heart damage [143,144] during ischemia, and that production of O 2 •− is ubiquitous during these pathophysiological events, spin trapping of O 2 •− by nitrones in mildly acidic environment is therefore relevant.…”

Section: Reactivity Of Nitrones To Superoxidementioning

confidence: 99%

Potential Implication of The Chemical Properties and Bioactivity of Nitrone Spin Traps for Therapeutics

2012

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Nitrone therapeutics has been employed in the treatment of oxidative stress-related diseases such as neurodegeneration, cardiovascular disease and cancer. The nitrone-based compound NXY-059, which is the first drug to reach clinical trials for the treatment of acute ischemic stroke, has provided promise for the development of more robust pharmacological agents. However, the specific mechanism of nitrone bioactivity remains unclear. In this review, we present a variety of nitrone chemistry and biological activity that could be implicated for the nitrone’s pharmacological activity. The chemistries of spin trapping and spin adduct reveal insights on the possible roles of nitrones for altering cellular redox status through radical scavenging or nitric oxide donation, and their biological effects are presented. An interdisciplinary approach towards the development of novel synthetic antioxidants with improved pharmacological properties encompassing theoretical, synthetic, biochemical and in vitro/in vivo studies is covered.

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Systemic Acidosis in Acute Myocardial Ischemia

Cited by 8 publications

References 13 publications

Mechanisms Underlying the Emergence of Post-acidosis Arrhythmia at the Tissue Level: A Theoretical Study

Mechanisms Underlying the Emergence of Post-acidosis Arrhythmia at the Tissue Level: A Theoretical Study

Is It Possible to Maintain Consciousness and Spontaneous Ventilation with Chest Compression in the Early Phase of Cardiac Arrest?

Potential Implication of The Chemical Properties and Bioactivity of Nitrone Spin Traps for Therapeutics

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